How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $1,445.44 Typical High $1,445.44 | Professional | None | $251.19 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $165.96 Typical High $223.87 | Facility | None | $123.03 | $165.96 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Emblem Health Setting Facility Modifier None Typical Low $151.36 Median $537.03 Typical High $3,090.30 | Facility | None | $151.36 | $537.03 | $3,090.30 |
Emblem Health Setting Professional Modifier None Typical Low $275.42 Median $2,570.40 Typical High $2,570.40 | Professional | None | $275.42 | $2,570.40 | $2,570.40 |
Excellus BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,570.40 | $2,630.27 | $2,630.27 |
Excellus BCBS Setting Professional Modifier None Typical Low $2,570.40 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,570.40 | $2,630.27 | $2,630.27 |
MVP Health Care Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $5,495.41 | Facility | None | $2,187.76 | $2,187.76 | $5,495.41 |
MVP Health Care Setting Professional Modifier None Typical Low $1,548.82 Median $1,737.80 Typical High $3,235.94 | Professional | None | $1,548.82 | $1,737.80 | $3,235.94 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Univera Setting Facility Modifier None Typical Low $2,570.40 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,570.40 | $2,630.27 | $2,630.27 |
Univera Setting Professional Modifier None Typical Low $2,570.40 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,570.40 | $2,630.27 | $2,630.27 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $144.54 |
Where New York sits
The same service costs 21.9 times more in Wyoming than in North Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New York· 14th of 51
$1,445
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.